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Non-invasive medical imaging technologies capture more comprehensive histological information of burn wounds beyond surface characteristics.

Research findings published in the International Wound Journal suggest use of non-invasive medical imaging technologies captures more comprehensive histological information of burn wounds beyond surface morphological characteristics. Jing Li, and colleagues said use of this technology allows for a better assessment of tissue depth in patients with burns.

“Currently, the clinical diagnosis of burn depth primarily relies on physicians’ judgements based on patients’ symptoms and physical signs, particularly the morphological characteristics of the wound,” they wrote. “This method highly depends on individual doctors’ clinical experience, proving challenging for less experienced or primary care physicians, with results often varying from one practitioner to another.”

To better understand various non-invasive technology, the authors reviewed medical imaging options that have shown potential in burn depth diagnosis. They summarized the technologies based on imaging principles, current research status, advantages and limitations, and those aiming to provide a reference for clinical application or research for burn specialists.

An Examination of Available Options for Physicians

Laser Doppler Imaging (LDI) is a non-invasive imaging technique that uses laser light to assess blood perfusion in tissues, the researchers explained. It has been extensively used in the diagnosis of burn depth, with studies showing its accuracy in diagnosing burns within the first week post-injury. However, LDI has limitations, such as the lack of standardized measurement parameters and the need for the imaging area to be kept still during scanning, which makes it unsuitable for assessing large burn areas or tracking the healing process.

Laser Speckle Imaging (LSI) is another non-invasive technique that uses laser light to assess blood perfusion in tissues. According to the paper, it has been shown to correlate with the severity of burns and can accurately predict wound healing time. LSI has the advantage of rapid image capture and high spatial resolution compared with LDI.

Spectral Imaging is a non-invasive imaging technique that uses multiple spectral bands of light to obtain information about tissue components, Li and colleagues wrote. It can be classified into multispectral, hyperspectral, and ultraspectral imaging based on spectral resolution capability. Hyperspectral imaging has been shown to accurately assess burn severity and predict healing outcomes. Near-infrared spectral imaging and spatial frequency domain imaging are additional types of spectral imaging that have shown potential in assessing burn depth.

Two-dimensional optical camera imaging combined with artificial intelligence (AI) image processing techniques is a rapidly developing area in burn depth assessment. The study authors wrote that it involves extracting features like color, shape, texture, and morphology of the burn wound and using AI classifiers to differentiate burn depth levels. This method has shown promising results in assessing burn depth and area, especially in field triage settings, Li and colleagues wrote.

Optical coherence tomography uses near-infrared light to create images of tissues. According to the paper, it has been used to assess burn depth by measuring the denaturation of collagen and observing morphological changes associated with burns.

Photoacoustic imaging is an emerging imaging technique that uses laser light to generate ultrasonic waves in tissues, they said. This imaging has accurately assessed burn depth and can monitor changes in the wound. However, it may have limitations in distinguishing between superficial burns and contaminants or melanin on the skin surface.

The Future of Burn Care

Overall, these non-invasive imaging techniques offer promising approaches for assessing burn depth and monitoring the healing process, Li and colleagues highlighted. They have the potential to improve clinical decision-making and patient outcomes in burn care.

“This approach not only avoids the subjective variances of human judgement but also significantly enhances the accuracy and consistency of diagnoses,” the authors wrote. “Although current imaging techniques still face barriers in technology, equipment and cost and have not yet been widely adopted in clinical practice, with continual advancements in imaging technology and equipment, the complementary use of various imaging modalities, combined with technologies like artificial intelligence, will play an increasingly important role in the diagnosis of burn depth in the future.”